KPC-3 Carbapenemase Harbored in FIIk Plasmid from Klebsiella pneumoniae ST512 and Escherichia coli ST43 in the Same Patient
KPC-3 Carbapenemase Harbored in FIIk Plasmid from Klebsiella pneumoniae ST512 and Escherichia coli ST43 in the Same Patient
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DOI：
10.1089/mdr.2013.0152
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发表时间：
2014-10-01
影响因子：
2.6
通讯作者：
Mazzariol, Annarita
中科院分区：
文献类型：
--
作者：
Kocsis, Erika;Lo Cascio, Giuliana;Mazzariol, Annarita
2009年至2012年期间，在意大利维罗纳大学医院对肠杆菌科抗生素耐药决定簇和质粒谱进行流行病学分析期间，分离出5株碳青霉烯类耐药菌株（3株肺炎克雷伯菌、1株大肠埃希菌和1株产气肠杆菌）。5株中有2株为K. pneumoniae E530和E.大肠杆菌E558，分别从一个病人的胆汁和腹腔引流培养。对β-内酰胺类和氟喹诺酮类耐药，对替加环素和粘菌素敏感。所有菌株均携带bla（KPC-3）、bla（TEM-1）和bla（OXA-9），三株K.肺炎克雷伯氏菌还携带blaSHV-11和aac（6 '）Ib。将bla（KPC-3）插入转座子Tn 4401 a中。所有菌株均携带FIIk型质粒，三株K. pneumoniae共携带colE型质粒。除了bla（KPC-3）外，接合子还含有bla（TEM-1）和bla（OXA-9）基因。K. E301属于ST 258，E530和C525属于ST 512;大肠杆菌E558为ST 43。据我们所知，这是第一份强烈支持ST 512 K传输bla（KPC-3）的报告。pneumoniae为E.大肠杆菌ST 43在一个单一的病人，一个现象的临床和微生物学的重要性。
Five carbapenem-resistant strains (three Klebsiella pneumoniae, one Escherichia coli, and one Enterobacter aerogenes) were isolated between 2009 and 2012 at the Verona University Hospital, Italy, during an epidemiological analysis of antibiotic resistance determinants and plasmid profiles in Enterobacteriaceae. Two out of the five strains, K. pneumoniae E530 and E. coli E558, were cultured from bile and abdominal drainage, respectively, of a single patient. The strains were resistant to beta-lactams and fluoroquinolones, and susceptible to tigecycline and colistin. All the strains harboured bla(KPC-3), bla(TEM-1), and bla(OXA-9), and the three K. pneumoniae additionally carried blaSHV-11 and aac(6')Ib. The bla(KPC-3) was inserted in transposon Tn4401a. All the strains hosted an FIIk-type plasmid, and the three K. pneumoniae coharboured an colE-type plasmid. Transconjugants, besides bla(KPC-3), harboured bla(TEM-1) and bla(OXA-9) genes on FIIk-type plasmid. K. pneumoniae E301 was ST258, while strain E530 and C525 belonged to the ST512, and E. coli E558 was ST43. To our best knowledge, this is the first report that strongly supports the transmission of bla(KPC-3) from ST512 K. pneumoniae to E. coli ST43 in a single patient, a phenomenon of both clinical and microbiological importance.